Thursday, December 03, 2015

The Macro View - General And Health News Relevant To E-Health And Health In General.

December 03 Edition
With Parliament back for the last time before Christmas we are seeing a flurry of activity. A Mental Health Strategy with a lot of e-Health components, changes to Super, a new Competition Policy and a quieter phase on the planned changes to the GST.
Lots to catch up with this week.
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Here is some other of the recent other news and analysis.
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General Budget Issues.

Packet of 25 cigarettes to cost more than $40 by 2020 under Labor

By political reporter Eliza Borrello
The Labor Party has announced a plan which would see a packet of 25 cigarettes cost more than $40 by 2020.

Key points:

  • Labor unveils election plan to gradually increase tax on cigarettes
  • Plan would see pack of 25 cigarettes cost more than $40 by 2020
  • Shorten says plan shows "stark" difference from Government
The price rise would stem from gradual increases in the tax on cigarettes continuing beyond 2017, if Labor is elected.
The Opposition said the policy would generate savings of almost $50 billion over the medium term and almost double the rate at which people quit smoking.
"Money that we want to put towards budget consolidation but also towards very important health initiatives," Labor's health spokeswoman, Catherine King, said.
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Lower tax dream feeds budget deficit

Date November 23, 2015

Ross Gittins

The Sydney Morning Herald's Economics Editor

Remember when we used to worry about the budget deficit? In case you've stopped following the story, recent developments are well summarised by a crikey.com headline: Lucky we don't have a revenue problem, because revenue looks bad.
The big budget news last week was that wages grew by just 2.3 per cent over the year to September, taking wage growth in the private sector - of 2.1 per cent - to its lowest in the 18-year history of the wage price index.
Add to that the recent weakness in iron ore and other commodity prices and it won't be surprising to find Treasury revising down its revenue forecasts yet again when we see the mid-year budget review next month.
The closer the review's publication is to Christmas, the more anxious we'll know the government is to avoid having us realise how far the Coalition's concern about debt and deficit has receded.
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Lazy option? Bill Shorten's cigarette tax is actually a breath of fresh air

Date November 24, 2015 - 7:51PM

Mark Kenny

Chief political correspondent

ANALYSIS

Labor targets smoking for huge tax hike

Cigarettes could cost an extra $10 per pack under a new proposal from Labor.
Labor's trip to the well for yet another dip at tobacco excise feels like the lazy option for budget repair.
Poor people are indeed more likely to smoke ... and die younger. How's that for equity? 
Until that is, you listen to the public policy arguments because, frankly, they are pretty compelling.
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Why Labor’s tobacco tax could be an alcopop flop

11:00pm, Nov 24, 2015
Rob Burgess
Economics commentator
ANALYSIS: Labor’s planned tobacco excise hike has noble intent, but could still backfire.
Labor’s new plan to increase the excise rate on tobacco will provoke an emotional response in many people – it’s natural to be outraged by the addiction, health effects and premature deaths caused by tobacco.
The problem is, outrage sometimes leads to sloppy law-making and can cause more harm than it reduces.
A powerful example was seen under the Rudd government in the form of the ‘alcopops tax’.
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  • Nov 24 2015 at 4:53 PM
  • Updated Nov 24 2015 at 7:47 PM

Competition review: Turnbull embraces Harper, now he must take on the vested interests

Malcolm Turnbull has embraced the Harper review's reform agenda, but will he have the courage to take on the vested interests?

Probably the most important keys to the success of Malcolm Turnbull's government are tax reform and the Harper committee's proposed for reforms of government services.
Without them, it is doubtful that the Prime Minister and his Treasurer, Scott Morrison, will ever achieve lasting fiscal problem.
The Harper review is more than just an exercise in mopping up the leftovers of the 1980s and 1990s reforms. The changes mapped out in its report could revolutionise the provision of government services, from healthcare to the provision of roads and public transport.
At the same time, its broader competition policy reforms would add to productivity.
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5:14pm November 24, 2015

Surplus return may take longer: Treasury

AAP
Treasury has cut Australia's potential economic growth forecast, while predicting a return to a budget surplus will take longer than previously forecast.
As the Turnbull government finally responded to the Harper review into competition law, saying reforms should lift economic growth, Treasury deputy secretary Nigel Ray says potential growth will be about 2.75 per cent over the next few years.
This is lower than the three per cent predicted in the May budget, the result of slower population growth and labour force trends, Mr Ray said.
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Harper review: Competition reforms to ‘end decline in growth’

  • The Australian
  • November 25, 2015 12:00AM

David Uren

Scott Morrison has declared that a new era of competition reform will reverse the long decline in Australia’s productivity, as the federal government offered financial rewards to state governments that open their health and welfare services to competition and remove barriers to trade.
The Treasurer has foreshadowed that consumers will benefit from reforms ranging from road pricing to cheaper books, longer shopping hours and greater choice in government-funded services.
Releasing the government’s ­response to the review of competition policy led by professor Ian Harper, Mr Morrison said: “The government wants to unleash a spirit of competition, to put Australian consumers and choice front and centre, because it is the economy and all Australians that ultimately will be the winners.”
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Cost of living comparison shows necessities taking an increasingly bigger bite out of family budget

November 27, 2015 1:00am
Jackie SinnertonThe Courier-Mail

How to put on a Christmas feast without overspending

IT HAS never been cheaper for Queenslanders to buy mobile phones, clothes and take a holiday but utilities, education, health and housing continue to savage the family budget.
An exclusive comparison of cost of living data from the Australian Bureau of Statistics shows that between 2005 and September 2015 utilities spiked by almost three times more than wage rises.
“Sadly, the only things that have remained cheap over the decade are the things people can live without while the necessities of life continue to soar,” AMP financial adviser Anthony Jones said.
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Give it to us straight on the brutal budget facts

  • The Australian
  • November 26, 2015 12:00AM

David Uren

Wayne Swan’s 2010 budget speech was a classic, declaring that it met the highest standards of responsible economic management by setting “a strategy that will see the budget return to surplus in three years’ time, three years ahead of schedule and ahead of every major advanced economy”.
Since then, every time the treasurer — both Swan and his successors — has looked at the budget, the outlook has been worse than expected. Some of the euphoria that accompanied change of political leadership will evaporate when Scott Morrison releases his first budget statement about 10 days before Christmas.
It will be a sober document showing all the sound and fury over budget savings during the past five years has been for nought. The task of budget repair and repaying the debt is bigger than ever.
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Capex slide puts budget forecasts in doubt

Date November 26, 2015 - 7:46PM

Peter Martin

Economics Editor, The Age

Business investment is collapsing at a record pace as resource companies accelerate cutbacks amid slides in coal, iron ore and gas prices.
New capital expenditure figures released on Thursday show investment collapsed 9.2 per cent in the September quarter – the biggest quarterly slide since records began almost 30 years ago.
The 9.2 per cent slide eclipses those recorded during the early-1990s recession and the global financial crisis.
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Health Budget Issues.

Radical plan to ‘simplify’ healthcare, paying for treatments in Australia: report

November 23, 2015 12:00am
Sue Dunlevy National Health Reporter News Corp Australia Network
THE subsidy for private health insurance would be scrapped and instead the government would pay 40 per cent of the cost of all hospital treatment under radical reforms.
The proposal being considered by the government as part of its health insurance reforms would dramatically simplify the health system.
It would mean the federal government paid 40 per cent of the cost of any hospital treatment whether it was in the public or private system.
The states would have to foot the bill for the other 60 per cent of public hospital costs and insurers would have to pay that gap for those using the private system.
The 40 per cent government payment would mean health fund premiums would be lower, making up for the lost rebate.
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Medicare safety net modelling should be released, Senate committee says

Date November 23, 2015 - 6:57PM

Jane Lee

Legal affairs, health and science reporter

The Turnbull government should publish evidence justifying its planned changes to the extended Medicare safety net to hose down fears they will affect vulnerable patients, a government-dominated Senate committee says.
The changes will lower the spending thresholds required for patients to access benefits for out-of-hospital services but cap the benefits payable for individual services once this has been reached, prompting concerns that critical psychiatric and oncology services could become unaffordable for some patients.
The Senate standing committee on community affairs, controlled by Coalition senators and chaired by Liberal Senator Zed Seselja, recommended that the bill be passed, saying it would resolve inconsistencies in the program, which had been inequitable, inflationary and failed "to deliver affordable access to high quality health care" over more than a decade.
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Asthma costs Aust $28b a year: report

November 23, 201511:30pm
AAP
Asthma costs Aust $28b a year: report
Asthma is costing Australia $28 billion a year, with most of the bill related to disability and premature death.
Direct healthcare costs total $1.2b, says a new report by Deloitte Access Economics, commissioned by Asthma Australia and the National Asthma Council Australia.
The Hidden Costs of Asthma report details the financial impacts on government, families and carers of people with the disease.
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Doctors call for target to close gap on indigenous incarceration rates

Date November 25, 2015 - 4:58PM

Jane Lee

Legal affairs, health and science reporter

Doctors are calling on the Turnbull government to set a national target for closing the gap between Indigenous and non-Indigenous imprisonment rates.
The Australian Medical Association said on Wednesday that Aboriginal and Torres Strait Islanders, who were less likely to have seen a GP or health service provider before being incarcerated, were often only diagnosed with chronic health conditions“, including mental health and substance abuse problems and cognitive disabilities, when they entered prison.
It's just not credible that Australia, one of the world's richest nations, cannot solve a health and justice crisis that affects three per cent of our population. 
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Medicare to fund 'tailored' services for severely mentally ill

Date November 26, 2015 - 12:01AM

Jane Lee

Legal affairs, health and science reporter

People suffering severe mental illnesses will be able to access Medicare benefits for drug and alcohol addiction services as part of treatment programs tailored to their conditions.
Health Minister Sussan Ley said on Wednesday that the government would subsidise "complex care services" that health professionals recommended for people with severe mental illnesses. She said this would go beyond psychological services to include mental health nursing, drug and alcohol services, vocational assistance, peer support and care coordination support. 
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10:08am November 25, 2015

Aged care red tape being cut

AAP
The federal government is streamlining regulations for aged-care homes.
Aged Care Minister Sussan Ley said a bill she introduced to parliament on Wednesday would remove "an unnecessary and administratively burdensome" form from the process of transferring a person from one facility to another.
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Government rushing to pass Medicare safety net changes despite calls to release impact modelling

Date November 26, 2015 - 9:28AM

Jane Lee

Legal affairs, health and science reporter

The Turnbull government is rushing to pass changes to the Medicare safety net without releasing details on the extent of their impact on chronically ill patients.
The bill, which will lower the thresholds needed to access benefits for out-of-hospital services while capping the amount payable for individual services once these have been reached, has faced fierce opposition from psychiatric, oncology and IVF groups concerned it will make services unaffordable for some patients.
A government-controlled Senate committee, chaired by Liberal Senator Zed Seselja recommended on Monday that data that revealed the expected impact of the changes be released, saying failing to do so had partly "caused unnecessary angst and confusion" among stakeholders.
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Mental health's huge economic impact: PM

Updated: 10:37 am, Thursday, 26 November 2015
Prime Minister Malcolm Turnbull has emphasised the impact mental health has on Australia's economy while releasing a shake-up of federal funding for services.
The government spent about $10 billion annually for mental health treatment which needed to be delivered more effectively, he told reporters in Parliament House on Thursday.
'The impact of depression and other mental illnesses on our productivity, I think all of us know this if not from personal experience from friends and family ... is enormous,' Mr Turnbull said.
Mental illness 'gnaws away' at productivity and offering indivdualised care packages would be 'transformative', he said.
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Huge variations in surgery and mental health treatment across Australia

Date November 26, 2015 - 11:31AM

Jane Lee and Julia Medew

Residents of Melbourne's wealthy bayside suburbs are among the highest users of colonoscopies in Australia while their poorer neighbours in Frankston top the state for using mental health plans for psychological care.  
A new atlas of health care has also revealed that children under the age of 17 in Sale have the highest rate of antidepressant drug use in Victoria, while people over 65 in Melbourne's wealthy inner south-eastern suburbs are Australia's greatest users of anti-psychotic medicines.
In a worrying discovery, there are huge variations in surgery across Australia, too, with women in Victoria's Latrobe Valley having the highest rate of hysterectomies (removal of the uterus) - five times higher than other areas. And children under 17 in Glenelg are the most likely in Australia to have their tonsils removed. The town in the Southern Grampians has six times the rate of tonsillectomies compared to other parts of the country.   
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Early intervention to fight mental illness in new reforms

  • The Australian
  • November 26, 2015 10:40AM

Jared Owens

The Turnbull government has framed its blueprint to modernise mental health services as a “structural reform” that will address the “staggering” cost of psychological illness to the economy.
Announced in Canberra today, the reforms feature a “stepped care” model that will see Australians receive treatment and support depending on their level of need, rather than the current “one-size-fits-all” approach.
Health Minister Sussan Ley said, for instance, the “modern, flexible and nimble” model would enable at-risk young people to access professional counselling online, rather than languishing on a waiting list or finding solace in “dark places on the internet”.
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Primary Health Care hits back at government rhetoric on waste

Date November 26, 2015 - 4:19PM

Tim Binsted

Reporter

The denigration of doctors must stop if reforms of the health system are to achieve real change, Primary Health Care chief executive Peter Gregg has warned.
Primary is a major provider of imaging, pathology, and GP services, and faces revenue pressure if any of the numerous federal health reviews under way recommend fee cuts or changes to the way care is provided.
If the freeze persists, GPs may be forced to charge co-payments. 
Peter Gregg, CEO, Primary Health Care
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Government announces mental health system overhaul but no extra funding

Date November 26, 2015 - 5:22PM

Jane Lee

Legal affairs, health and science reporter

Structural reform for mental health

The government's reforms to the mental health sector will focus on individual needs says Health Minister Sussan Ley.
Australia's mental health care system will be overhauled to provide more local services tailored to people's illnesses over the next three years, but may require significantly more funding to be completed.
Health Minister Sussan Ley on Wednesday announced a range of changes to the system in response to the National Mental Health Commission's 2014 review of mental health services, without any additional funding. 
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Mental health: implementation the key to structural reforms

Date November 26, 2015 - 11:45PM

Sebastian Rosenberg

The federal government has finally revealed its response to the Review into Mental Health Services conducted by the National Mental Health Commission. The changes announced by Minister Sussan Ley do not offer a neat new bundle of funded programs. But they do offer two important structural reforms with very significant potential, including in relation to funding.
First they place Primary Health Care Networks (PHNs) squarely in the leadership role for regional planning for mental health. Given the size of some of the PHNs, they may need to make more than one plan to ensure they are truly reflecting local needs. But it is clearly in their remit to ensure the mental health needs of their communities are properly understood and that there is an organised response. Central to this response is the concept of 'stepped care'.
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Private health insurance reform: prevention the key to cure

  • John Dwyer
  • The Australian
  • November 27, 2015 12:00AM
The worst possible outcome from the review of private health insurance would be changes that resulted in the best resourced primary care being available only to those who have such ­insurance.
Obviously, insurers and the insured would be expecting a ­service superior to that available to the non-insured.
We need to improve the way we ­deliver primary and community care to meet contemporary needs but also those improve­ments must be available to all. This requirement is not just about equity; it’s also about rational health economics.
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Superannuation Issues.

Superannuation caps won't mend the budget

Date November 23, 2015 - 12:15AM

Matthew Knott

Communications and education correspondent

Putting a lifetime cap on superannuation contributions, an idea under consideration by the Turnbull government, would do little to repair the budget and could potentially blow out the deficit, according to new modelling.
Treasury officials have been exploring options to remove annual caps on how much money people can put into their superannuation in favour of a lifetime cap on contributions. 
Peak bodies representing retail and industry super funds, Deloitte Access Economics and the influential Grattan Institute think tank, have called for lifetime caps on the amount people can contribute to their superannuation accounts.
There is currently an annual cap of $180,000 on non-concessional superannuation contributions. Those aged under 65 can bring forward future contributions, but cannot contribute more than $540,000 over three years.
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Morrison wants to make super fairer for all

In his wide-ranging speech today about potential changes in the superannuation system, Treasurer Scott Morrison made the case for a fairer system on a range of measures.
One of the key principles the government will focus on is the need for flexibility in super for people with broken work patterns, which generally means women.
The tone of the Treasurer’s comments, which were made at the superannuation industry’s annual conference in Brisbane, indicated a keen understanding of how hard it is to catch up on super after taking breaks from the workforce -- whether to care for your children, or for your elderly and sick parents.
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Health Insurance Issues.

  • Nov 23 2015 at 6:47 PM
  • Updated Nov 23 2015 at 7:01 PM

Medibank forces hospitals to offer surgery 'warranty'

Medibank Private has forced Healthscope, Australia's second-biggest private hospital operator, to cover the cost of patients who are injured or become sick in its hospitals, a major shift in the power balance between insurers and hospitals.
Chief executive George Savvides ​ signed a two-year contract with Healthscope on Monday that he said was a "tipping point" in his campaign to slow rises in health policy premiums, which rose 6.2 per cent this year.
The health insurer has been in a bruising public fight over the introduction of "quality and affordability" criteria into contracts with hospitals.
The new contracts make hospital providers cough up for medical claims that result from poor quality care. Medibank refuses to pay if a patient returns to hospital within 28 days after surgery due to complications. It also refuses to pay for any of 165 "hospital acquired complications", such as an incorrect blood transfusion, a fall while in care or bed sores, which it says should not occur in good quality hospitals.
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Health insurers need to get back to basics

In an overly complex and unsustainable private health insurance market, consumers have more than 20,000 policies to choose from.
While there are no fewer than five government reviews of the sector that will eventually lead to regulatory reform, analysts at Credit Suisse have identified some quick fixes that could make private health insurance both more affordable for consumers and more sustainable.
But for listed insurers like Medibank Private and NIB Holdings, shareholders may have to swallow lower returns.
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Pharmacy Issues.

Not hearing the message

23 November, 2015 Chris Brooker 
Pharmacists are unsure if the Sixth Community Pharmacy Agreement represents a turnaround for the profession’s future.
While Pharmacy Guild of Australia leaders and others hailed the agreement as a turning point in the move toward payment of professional services and other non-PBS items, it appears the broader profession is unsure about the significance of this. 
As revealed recently in Pharmacy News, there are renewed signs of optimism among community pharmacists, with a bounce in those expressing confidence in the future.
However, overall the level of confidence remains relatively low, and may still have neutral sentiment about their future – an ambivalence reflected in the profession’s summation of the 6CPA.
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PBS drugs save money and lives: report

November 23, 20157:15pm
By Belinda MerhabAAP
PBS drugs save money and lives: report
Listing medicines on the Pharmaceutical Benefits Scheme saves taxpayer dollars as well as lives, according to analysis by a renowned economist.
Frank Lichtenberg, professor of business at Columbia University, says premature mortality declined 25 per cent in Australia between 1998 and 2011, and 60 per cent of that is thanks to the listing of new drugs on the PBS.
His new report released by Medicines Australia on Tuesday estimates that in 2011, 140,000 Australians got to live one year longer than would have been the case if no new drugs had been listed in the previous 13 years.
In 2020, he estimates that number will jump to 308,000.
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8:37am November 25, 2015

No point making pharmacy change: O'Dwyer

AAP
The federal government is defending its decision to put off any move to deregulate pharmacies until at least 2017.
It has "noted" a recommendation by the Harper Review to remove restrictions on pharmacy ownership and location rules.
Assistant Treasurer Kelly O'Dwyer says there is no point in making changes now because the government has just signed new agreements with the Pharmacy Guild.
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Pharmacy review panel under fire

  • REBECCA URBAN
  • The Australian
  • November 26, 2015 12:00AM
The Pharmacy Guild of Australia has hit out at the appointment of two outspoken advocates for deregulation to a government panel that could decide the future of the heavily subsidised industry.
Monash University economics professor Stephen King will chair the Pharmacy Remuneration and Regulation Review, which will consider longstanding pharmacy ownership and location rules.
Professor King, a former member of the Australian Competition & Consumer Commission who has criticised the pharmacy industry for being “anti-competitive”, will be joined on the panel by Jo Watson, deputy chairwoman of the Consumers Health Forum, which has called for ownership and location rules to be scrapped.
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Pharmacists to give vaccines and manage chronic diseases in Victoria

Date November 26, 2015 - 1:15AM

Julia Medew

Pharmacists will take on some doctors' tasks under a controversial plan to allow Victorian patients to see pharmacists for vaccines and chronic diseases such as diabetes and asthma.
Under a trial that has angered doctors, Victorian Health Minister Jill Hennessy said three pharmacies would test a partnership with GPs next year to "help patients manage their chronic illnesses and medications". 
People with high blood pressure, diabetes, asthma, chronic obstructive pulmonary disease and those on anti-coagulation therapies can be part of the trial which will involve two rural pharmacies and one in Melbourne.
The idea is that patients will be able to visit their local pharmacist to monitor their conditions and manage medications under the direction of a GP care plan.
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Health is also clearly under review as far as its budget is concerned with still a few reviews underway. Lots to keep up with here! Enjoy.
David.

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